While the number of programs dedicated to caring for people living with memory loss is increasing, knowing what to look for is key to finding the best provider. Here are a few pointers to help you as you investigate your options.
Dementia care providers can vary widely in their philosophy and delivery of care. Know what your loved ones unique needs are (does he/she wander? does he/she become agitated and pace more in the evenings?). As you tour care providers, ask them how they handle those specific needs. Also ask them relevant hypothetical questions like "How do you handle a patient who likes to rummage through others' belongings?" or "How do you cope with a patient who repeatedly asks the same questions?". This will help you understand if their delivery of care matches their philosophy of care. Alzheimer’s disease and dementia are progressive diseases. How does this community plan for those changes? Are there any circumstances under which your family member would be asked to leave?
Dementia impairs a person’s ability to make sense of the world around them. In structuring their environment to help support their remaining abilities, you help them maintain some sense of independence and dignity. Are signs at eye level? You will notice people living with Alzheimer’s disease or tend to look downward as they walk. Signs at eye level are more likely to be seen, especially if the signs have bright, contrasting colors with simple graphics. Key destinations (the bathroom, the dining room) should be easily visible. The environment shouldn’t have busy carpets or highly polished floors. Color-coded hallways also make it easier for a resident to find their way around. Some dementia care programs have doors camouflaged (i.e. painted the same color as the walls with no visible knobs) that they don’t want residents to attempt to use. Memory boxes with personal memorabilia or family photos at the entrance to a resident room make it easier for them to find their way back.
Nothing can replace an educated, committed and caring staff when it comes to working with individuals living with memory impairments. Compassion and respect for both residents and families should be evident. This is a difficult disease for family members to watch. They need support and understanding. Is that evident when you tour a community? If not, you need to keep looking. What backgrounds do the caregivers and clinicians have? What is their initial training and screening? How much training do they receive every year? Is the staffing adequate?
People with dementia have difficulty adjusting to change and to new activities and routines. Programming needs to accommodate residents’ disabilities, while encouraging his or her interests, remaining abilities, and role in the family. Ask the program services team how they do this. Does the programming start from the time a resident wakes up and go well in to the evening hours? Do you observe both activities and nursing staff (nurses and caregivers) engaging residents? Resident programming should support three basic goals: allow residents to feel productive, include opportunities for recreation, and provide assistance with activities of daily living.
If you select a memory care program in a long-term care center, payment is easier to understand. Just be sure to ask if there are any additional level of care charges that would be assessed on your family member as their disease progresses.
If you select an assisted living memory care program, ask lots of questions to clarify and what is and isn’t included in the monthly fee.
Ask what happens to the charges if your loved one needs more care and services? What happens if your family member runs out of private funds?